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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547209301
Report Date: 08/14/2024
Date Signed: 08/14/2024 10:27:54 AM

Document Has Been Signed on 08/14/2024 10:27 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SENIOR CARE COMFORT LIVINGFACILITY NUMBER:
547209301
ADMINISTRATOR/
DIRECTOR:		MELANIE RAFANANFACILITY TYPE:
740
ADDRESS:720 SOUTH CHINOWTH ROADTELEPHONE:
(559) 303-8043
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY: 6CENSUS: 0DATE:
08/14/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Licensee Melanie Rafanan and Jose PiraTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Licensing Program Analyst (LPAs) K.Kaur and J. Leffall conducted Pre-licensing follow up Inspection on this date. LPA met with Licensee Melanie Rafanan and Jose Pira. A tour of the facility was conducted together. This is a new facility with no residents in care. The facility was observed to be at a comfortable temperature, and in good repair. No passageway obstructions or fire hazards were observed inside or outside. Common areas were properly furnished and well-lit throughout.

The facility is a 3-bedroom, 1-bathroom home with a fire clearance for 6 non-Ambulatory. Licensee has made all corrections. Water temperature tested at 110 F. LPAs observed Liability insurance paperwork. Non-discrimination notice has been posted. All debris was cleared from back-yard and tools were moved to a locked location. Night stands were added to the bedrooms. Facility telephone number is 559-802-3166.

Component III was conducted during today's pre-licensing visit. Applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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